A Case of Corneal Involvement and Ophthalmoplegia in Herpes Zoster Ophthalmicus

Abstract

Purpose: To report a case of herpes zoster ophthalmicus with corneal involvement and rarely occurred ophthalmoplegia.Case summary: A 74-year-old man visited to the dermatology clinic for the pain and blistering of the forehead and around the right eye, which started 4 days ago. After the diagnosis of herpes zoster, he referred to our clinic to evaluate the ophthalmologic abnormality. At the initial visit, the skin around the right eye was scuffed, lid swelling was observed, and epiphora was noted. One week later, he complained of decreased visual acuity in his right eye and diplopia. On ophthalmic examination, there was ophthalmoplegia including complete ptosis in his right eye. By slit lamp biomicroscopy, corneal edema and conjunctival injection were observed. Oral antiviral agents were maintained and topical antiviral agent and steroid were administrated. Two months after the onset of skin lesion, ophthalmoplegia and ptosis were recovered except for lateral gaze limitation. All ocular abnormalities were fully recovered after 5 months of skin lesion.Conclusions: Ophthalmoplegia after herpes zoster ophthalmicus is very rare but it should be considered as one of the major complications that may occur. We experienced a case of ophthalmoplegia accompanied by corneal invasion and complete recovery after topical agent and oral antiviral therapy so we want to report this case with a review of the literature.